The family 'canary' country MIR clicks two switches

Although both parties in the government agree on the appropriateness of giving A New momentum for rural MIRThe proposal is far from firm. In fact, not even which model PSOE Your idea base runs like a well-oiled machine. In the interview given to Medical writingSocialist spokesman for the Senate Health Committee, Kilian Sanchezused the rotation system in his home country of the Canary Islands as a reference to present his idea, but from the insulting delegation of the Spanish Society of Primary Care Physicians (Semirgin) They stress that MIR de Familia Canario is not exempt from shortcomings: “There are not enough teaching units or teaching doctors.”

President of Simergin Canarias, Vanessa Deniseremember that commitment to be a part of Family medicine residency in a rural area It is already in place throughout Spain. “The other thing is that it can be done,” he points out. The doctor recalls that health centers are divided into G1, G2, G3 and G4 depending on whether they are located in an urban, semi-urban or rural area, the number of patients they care for and the distance to the hospital. And in an area like the Canary Islands Isolated character This is an obstacle that exacerbates the distance between rural areas and cities.

Overwork for family doctors

the Training Guide/Itinerary for Family and Community Medicine Resident in the Government of the Canary Islands It includes a mandatory rotation at a rural health center, according to Program of Official Specialization (POE) of MIR for Family, which stipulates that the aforementioned rotation will last for three months and should preferably take place in the second year of residency. In this regard, national regulations specify that if a MIR teaching unit belongs to a reference area or a region without any rural area, it can be linked to centers of these characteristics from other units until rotation is achieved. But there is a distance between words and deeds. “The essence of the matter is that it cannot be guaranteed to do so because there is a shortage of teaching units and teachers,” says Deniz.

The reasons for this circumstance are many. “The only thing they give you to work in places like San Nicolas, Tejeda or Artenara, overseas, is an extra day of vacation a year, with the obligation to do continuous care shifts, because there is no emergency service in the hospital,” the specialist details. “There are G4 health centres, which include several regions Primary health careHe adds: “There is often only one doctor, and the same doctor covers the emergency area morning, afternoon and night, or afternoon, night and morning.”

Incompatibility between the MIR Directive and the health agenda

he Ministry of Health is responsible for granting, each year, Accreditation of FSE educational modules. For the 2023-2024 call, 390 applications were received, according to sources from the department. the Requirements for obtaining accreditation to train specialists in nursing and family and community medicine It was included in Order PRE/861/2013 of 9 May. Among other things, the applicant's centre, whether urban or rural, must have at least: Four specialist doctors. This is far from the reality that Deniz describes.

“There are exceptions, because if that were not the case, it would be impossible to have teachers in some fields,” highlights the doctor, who, however, depicts The “unsustainable” outlook.. According to Deniz, it is “recommended” that the family guardian be responsible for the resident year after year, but this is not true in all cases.

“I know colleagues who have residents every year because There are not enough teachersAnd they don't give you anything extra for it. You have no fewer patients per schedule, no more training days, no more vacation days, and no more personal days. Finally, you have to set the agenda for each day, as well as explain to the resident everything you are doing.

President Semergen Canarias even explains her personal experience during her eighteen years as a primary care physician: “There were times when I had, at the same time, a university student and a resident. The attention that one needs and the attention that the other needs have nothing to do with each other. monitor both, There were resident rotation goals that were impossible to achieve In just one month.”